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RT Journal Article
SR Electronic
T1 Magnetoencephalography for Pediatric Epilepsy: How We Do It
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 832
OP 837
DO 10.3174/ajnr.A1029
VO 29
IS 5
A1 Schwartz, E.S.
A1 Dlugos, D.J.
A1 Storm, P.B.
A1 Dell, J.
A1 Magee, R.
A1 Flynn, T.P.
A1 Zarnow, D.M.
A1 Zimmerman, R.A.
A1 Roberts, T.P.L.
YR 2008
UL http://www.ajnr.org/content/29/5/832.abstract
AB SUMMARY: Magnetoencephalography (MEG) is increasingly being used in the preoperative evaluation of pediatric patients with epilepsy. The ability to noninvasively localize ictal onset zones (IOZ) and their relationships to eloquent functional cortex allows the pediatric epilepsy team to more accurately assess the likelihood of postoperative seizure freedom, while more precisely prognosticating the potential functional deficits that may be expected from resective surgery. Confirmation of clinically suggested multifocality may result in a recommendation against resective surgery because the probability of seizure freedom will be low. Current paradigms for motor and somatosensory testing are robust. Paradigms allowing localization of those regions necessary for competent language function, though promising, are under continuous optimization. MR imaging white matter trajectory data, created from diffusion tensor imaging obtained in the same setting as the localization brain MR imaging, provide ancillary information regarding connectivity of the IOZ to sites of rapid secondary spread and the spatial relationship of the IOZ to functionally important white matter bundles, such as the corticospinal tracts. A collaborative effort between neuroradiology, neurology, neurosurgery, neuropsychology, technology, and physics ensures successful implementation of MEG within a pediatric epilepsy program.